Diabetes Management and Food Access in Individuals with Diabetes Using Free and Fee-for-Service Clinics in Rural Appalachian Ohio

Diabetes Management and Food Access in Individuals with Diabetes Using Free and Fee-for-Service Clinics in Rural Appalachian Ohio

TUESDAY, SEPTEMBER 27 POSTER SESSION: WELLNESS AND PUBLIC HEALTH Diabetes Management and Food Access in Individuals with Diabetes Using Free and Fee-...

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TUESDAY, SEPTEMBER 27

POSTER SESSION: WELLNESS AND PUBLIC HEALTH Diabetes Management and Food Access in Individuals with Diabetes Using Free and Fee-for-Service Clinics in Rural Appalachian Ohio

Dietetic Students Leading the Way: A Service Learning Project to Support the Haitian Relief Initiative

Author(s): K. A. Brown,1 A. L. Burkley,1 D. H. Holben,1 J. H. Shubrook,2 F. L. Schwartz2; 1School of Applied Health Sciences and Wellness, Ohio University, Athens, OH, 2College of Osteopathic Medicine, Ohio University, Athens, OH

Author(s): I. T. Forrester,1 S. Brown,1 R. Rowel,2 C. Tucker,3 A. Taylor2; 1Morgan State University, Baltimore, MD, 2School of Community Health and Policy, Morgan State University, Baltimore, MD, 3Nutritional Sciences Program, Morgan State University, Baltimore, MD

Learning Outcome: After this presentation, the learner will be able to describe differences in food security status and a variety of clinical parameters between adults with diabetes receiving care from free or fee-for-service (fee) clinics in rural Appalachian Ohio. Background: Food insecurity is associated with poor management of diabetes (DM). Research Outcome: This study examined differences between household food security (HFS), household adult food security (HAFS), BMI, HgbA1c, total (TC), LDL, and HDL cholesterol levels, and blood pressure [systolic (SBP) and diastolic (DBP)] among adults with DM receiving care from free or fee-forservice (fee) clinics in rural Appalachian Ohio. Methods: Validated USDA measures of HFS and HAFS and medical record data were used. Using PASW Statistical Software (version 18.0, 2009), differences were determined between groups for HFS and HAFS (Mann-Whitney U) and BMI, HbgA1c, TC, LDL, HDL, SBP, and DBP (t-tests). Pearson correlation was used to assess the relationship of HFS and AFS to HgbA1c. Results: Participants (n⫽166) (free, n⫽41; fee, n⫽125) were 53⫾16 years and primarily Caucasian (n⫽147, 91.9%). Of those reporting DM status (n⫽155), most had type II (n⫽102, 65.8%). Overall, (61.1%), 29 (17.9%), 17 (10.5%), and 17 (10.5%) had high, marginal, low, and very low HFS, respectively. Similarly, 99 (61.1%), 29 (17.9%), 16 (9.9%), and 18 (11.1%) had high, marginal, low, and very low HAFS, respectively. Both HFS (p⬍0.001) and HAFS (p⬍0.001) differed between the clinic groups, as did HgbA1c (free, 8.7⫾1.7%; fee, 7.8⫾1.6%; p⫽0.005). Other variables did not differ (p⬎0.05). HgbA1c increased as HFS (r⫽0.293, p⬍0.001) and HAFS (r⫽0.288, p⫽0.001) worsened.

Learning Outcome: To be able to discuss the foods commonly consumed by Haitians. Devastated by the January 2010 earthquake, the island of Haiti, and several local communities in particular, continue to grapple with food scarcity and malnutrition. Harvest for Haiti, a servicelearning project among Dietetic students was planned and implemented to provide sustainable relief of food, and other basic resources to orphanages in the Port-au-Prince area of Haiti. This project demonstrates the principles of planning, organizing, goal setting, team work, cultural awareness, and food needs assessment among Haitian children in orphanages. This study describes the process of planning and executing a large-scale food (and clothing) initiative to provide a continuous source of support for Haitian orphans. The principles may be applied to address emergency food, or other resource needs among various communities in the midst of a disaster. Funding Disclosure: None

Conclusions: HFS, HAFS, and HgbA1c differed between participants using free or fee-for-service rural diabetic clinics, and HgbA1c increased as food insecurity worsened. Further exploration of this is warranted in other regions and patient groups. Funding Disclosure: Diabetes Research Initiative, Ohio University, Athens, Ohio

Household Food Security and Physical Activity among Individuals with HIV/AIDS in Rural Appalachia

Food Insecurity in US School Children: An Analysis of SNDA III Data

Author(s): J. P. Schreibman,1 D. H. Holben,1 T. Basta,2 A. K. Bansah1; 1 School of Applied Health Sciences and Wellness, Ohio University, Athens, OH, 2Department of Social and Public Health, Ohio University, Athens, OH

Author(s): E. Bergman, L. Cashman, T. Englund; Nutrition, Exercise, and Health Sciences, Central Washington University, Ellensburg, WA

Learning Outcome: After this presentation, the learner will be able to state the food security status and physical activity level of individuals with HIV/AIDS living in rural Appalachia. Background: No studies have examined the household food security (HFS) and physical activity (PA) level of individuals with HIV/AIDS living in rural Appalachia. Research Outcome: This study examined the relationship of HFS to PA among individuals with HIV/AIDS living in rural Appalachia (West Virginia, Appalachian Ohio, Kentucky, and Pennsylvania). Methods: Participants (n⫽82) completed an online or paper survey that included validated measures of HFS (USDA short form) and physical activity. Data were analyzed using PASW statistical software (version 18.0, 2009) to determine the relationship between the variables (Kendall’s tau correlation). Results: Participants (n⫽82) were: a) 47⫾10 years; b)Caucasian (n⫽59, 72.0%), African American (n⫽14, 17.1%), Hispanic/Latino (n⫽4, 4.9%), or other races (n⫽5, 6.0%); c) Male (n⫽63, 76.8%), Female (n⫽18, 22.0), or transgendered (n⫽1, 1.2%); and d)diagnosed with HIV (n⫽47, 57.3) or AIDS (n⫽35, 42.7%). For all patients, 28 (34.1%), 10 (12.2%), 12 (14.56%), and 32 (39.0%) were living in households characterized as being high, marginal, low, and very low HFS, respectively. HFS did not differ between those with HIV and AIDS (p⫽0.428) Of those reporting activity (n⫽80), 26 (32.5%) were physically active. PA was not correlated with HFS (p⫽0.403) and did not differ between food security groups (p⫽0.273). Similarly, PA did not differ between those with HIV or AIDS.

Learning Outcome: The participant will be able to determine parameters related to food insecurity in US school children The purpose of this study was to determine the prevalence and associations of food insecurity in US school children. Data from 2,314 public school students and their parents who participated in a questionnaire from the third School Nutrition Dietary Assessment Study was used for analysis. Analysis revealed significant differences in the prevalence of food insecurity in school children. Parameters investigated included urbanicity, child age, school district poverty rate, household income, highest grade completed by either parent, number of parents in the household, child health status, primary language spoken at home, region of the country, child ethnicity, and child Body Mass Index (BMI). Examples of significant differences include: Children who were from urban settings had a greater chance of experiencing low or very low food security (LVLFS) (17.2 % of children) compared to those from suburban and rural settings (12.2 % and 9.7 % of children, respectively). Children from the lowest household income group experienced LVLFS more often than children from higher income groups (30.5 % of children from $0 to $30,000 household income compared to 7.7 % and 0.6 % of children in households with $30,000 to $70,000 household income or greater than $70,000 household income, respectively). BMI was greater for children who experienced LVLFS when compared to children who were food secure. Also, as parent education increased, food security improved. Research is needed to determine what factors lead to these disparities. Education programs are needed to help prevent food insecurity among US children. Funding Disclosure: National Food Service Management Institute

Conclusions: HFS was about 3.5 times higher in our rural Appalachian sample, compared to national averages. Programs should be developed that address this disparity, while encouraging physical activity among clients. Further exploration of this is warranted in other rural regions. Funding Disclosure: None

Journal of the AMERICAN DIETETIC ASSOCIATION / A-101